4092 1 Acute Renal failure

Question 1

ARF: most accurate measurement of fluid status

Answer 1

daily weights

Question 2

ARF: Amount of fluids to be taken per day

Answer 2

400 ml (insensible fluid loss) + previous days urine output

Question 3

ARF: for comfort give

Answer 3

ice chips

Question 4

ARF: Diuretic therapy is usually done with

Answer 4

Furosemide and Mannitol

Question 5

ARF: Hyperkalemia can be an indication for

Answer 5

dialysis

Question 6

ARF: If there is Emergency Hyperkalemia

Answer 6

give 50% dextrose and regular insulin

Question 7

ARF: for acidosis give

Answer 7

sodium bicarbonate

Question 8

ARF: avoid ___ substitutes

Answer 8

salt substitutes

Question 9

for Hyponatremia, you need to restrict

Answer 9

fluids

Question 10

Treat “normal” Hypocalcemia

Answer 10

• Calcium Carbonate
• Calcium Lactate
• Vitamin D

Question 11

treat Emergency Hypocalcemia with

Answer 11

Calcium Gluconate IV

Question 12

Hyperphosphatemia is treated by phosphate binders like

Answer 12

Aluminum hydroxide

Aluminum Carbonate

Question 13

Aluminum Carbonate (which is a phosphate binder) – if use for a long period, this can caused

Answer 13

dementia

Question 14

Aluminum hydroxide (which is a phosphate binder) – can cause

Answer 14

constipation so stool softener maybe given

Question 15

Calcium base phosphate binders – excrete phosphorus but increased

Answer 15

Calcium

Question 16

Emergency Hypermagnesemia: Give ___ ____

Answer 16

Calcium Gluconate

Question 17

Treat “normal” Hypermagnesemia with ___ ___

Answer 17

diuretic therapy

Question 18

ARF: Metabolic Acidosis is associated with what electrolyte status

Answer 18

Hyperkalemia

Question 19

treatment of metabolic acidosis that’s caused stomatitis

Answer 19

Shohl’s solution

Question 20

Hyperkalemia: Give Sodium ____ or Sodium ____

Answer 20

Sodium Bicarbonate

Sodium Lactate

Question 21

ARF: Dopamine Hydrochloride

Answer 21

used to dilate renal arteries promoting renal perfusion

Question 22

ARF: to improve renal perfusion, control of hypertension with the use of

Answer 22

ACE inhibitors, diet and weight control

Question 23

ARF: diet should be high in

Answer 23

CHO

Question 24

ARF: Screen parenteral fluids, all oral intake, and all medications for hidden sources of

Answer 24

potassium

Question 25

ARF: Monitor cardiac function and musculoskeletal status for signs of

Answer 25

hyperkalemia

Question 26

ARF: how should you address Metabolic Rate

Answer 26

reduce it by keeping patient on bed rest

Question 27

ARF tx: catheters

Answer 27

Avoid indwelling catheters if possible to prevent infection

Question 28

ARF tx: Bath the patient with

Answer 28

cool water

Question 29

ARF increases the risk for secondary

Answer 29

infections

Question 30

ARF can cause 2 kinds of changes in blood composition

Answer 30

anemia

platelet dysfunction

Question 31

ARF can impair the ability of the body to

Answer 31

heal wounds

Question 32

Uremic encephalopathy

Answer 32

brain disorder that occurs from ARF

Question 33

Normally the kidneys excrete ____ of urine per kg of body weight per hour

Answer 33

1 ml

Question 34

The normal urine output is

Answer 34

1500 to 2000 ml

Question 35

There are three phases of ARF:

Answer 35

1. Oliguric phase 2. Diuretic phase 3. Recovery phase

Question 36

In the oliguric phase, urine SG is

Answer 36

greater than 1020

Question 37

In the diuretic phase, K is

Answer 37

decreased

Question 38

HESI hint: in some cases, people with ARF may not experience

Answer 38

the oliguric phase; instead they go right to diuretic phase.

Question 39

In the oliguric phase, how much fluid should you give

Answer 39

just enough to replace what was lost (usually 400 ml per day)

Question 40

Sodium polystyrene (Kayexalate)

Answer 40

may be prescribed if K+ is too high.

Question 41

EFV, respiratory findings

Answer 41

dyspnea

Pulmonary edema

Question 42

Salt substitutes are high in

Answer 42

K

Question 43

Fluids and sodium in ARF patients

Answer 43

should both be limited

Question 44

ARF diet

Answer 44

low protein
high carb
moderate fat

Question 45

ARF: rationale for limiting protein

Answer 45

prevents the rise of BUN

Question 46

ARF is considered resolved when BUN and Cr

Answer 46

return to normal levels